Efficacy of bupivacaine injection after pulsed radiofrequency ablation in the management of trigeminal facial pain: A prospective, randomized, and double-blind study

Abstract

Objectives: To assess the effect of bupivacaine application following pulsed radiofrequency (PRF) ablation on trigeminal facial pain.

Methods: A total of 73 patients with trigeminal facial pain refractory to conservative therapy were randomized into 2 groups. Group I subjects underwent PRF ablation procedure, followed by the injection of 1 ml of bupivacaine. Whereas, Group II underwent the same procedure followed by the injection of 1 ml of normal saline. Pain relief duration, the time of onset of pain relief, and analgesic effect evaluated by numerical pain rating scale were considered as outcomes.

Results: Thirty-nine patients in Group I and 34 in Group II. The duration of pain relief in the 2 groups was comparable (5 months in Group I vs. 6 months in Group II, p=0.53). The onset of pain relief in the patients of Group I was shorter than Group II (0 days vs. 4.5 days, p<0.001). The binary logistic regression analysis revealed that the application of bupivacaine alone had a significant effect on the reduction of the intake of medications (p<0.05).

Conclusion: In situations involving patients who require rapid pain relief, bupivacaine injection following PRF ablation can be employed to provide immediate relief without subjecting the patients to the risks associated with major complications.

Keywords: atypical facial pain; bupivacaine; facial pain; pulsed radiofrequency; trigeminal neuralgia; trigeminal neuropathic pain.